Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Curr Opin Pulm Med. 2012 Jul;18(4):304-12. doi: 10.1097/MCP.0b013e328354a5f2.
Given the higher rate of malignancy of subsolid pulmonary nodules and the considerably lower growth rate of ground-glass nodules (GGNs), dedicated standardized guidelines for management of these nodules have been proposed, including long-term low-dose computed tomography (CT) follow-up (≥3 years). Physicians must be familiar with the strategic management of subsolid pulmonary nodules, and should be able to identify imaging features that suggest invasive adenocarcinoma requiring a more aggressive management.
Low-dose CT screening studies for early detection of lung cancer have increased our knowledge of pulmonary nodules, and in particular our understanding of the strong although imperfect correlation of the subsolid pulmonary nodules, including pure GGNs and part-solid nodules, with the spectrum of preinvasive to invasive lung adenocarcinoma. Serial CT imaging has shown stepwise progression in a subset of these nodules, characterized by increase in size and density of pure GGNs and development of a solid component, the latter usually indicating invasive adenocarcinoma.
There is close correlation between the CT features of subsolid nodules (SSNs) and the spectrum of lung adenocarcinoma. Standardized guidelines are suggested for management of SSNs.
鉴于亚实性肺结节恶性肿瘤的发生率较高，且磨玻璃结节（GGN）的生长速度相当低，因此已提出了专门针对这些结节的管理标准指南，包括长期低剂量计算机断层扫描（CT）随访（≥3 年）。医生必须熟悉亚实性肺结节的策略性管理，并能够识别出提示需要更积极管理的浸润性腺癌的影像学特征。
肺癌早期检测的低剂量 CT 筛查研究增加了我们对肺结节的认识，特别是对亚实性肺结节（包括纯 GGN 和部分实性结节）与肺腺癌的侵袭前到侵袭性病变谱之间的强烈但并非完美的相关性的理解。连续 CT 成像显示这些结节中的一部分呈逐步进展，其特征是纯 GGN 的大小和密度增加，实性成分的发展，后者通常提示浸润性腺癌。
亚实性结节（SSNs）的 CT 特征与肺腺癌的谱密切相关。建议对 SSNs 进行管理的标准指南。
